A study on the effect of topical lidocaine gel versus drops on surgeon’s comfort during manual small incision cataract surgery

Prakash Krishnan; Sancy Mary Sam; Sanitha Kuriachan; Nirmala Sethuraman

doi:10.18203/2319-2003.ijbcp20182950

Authors

Prakash Krishnan Department of Pharmacology, Al Azhar Medical College and Super Speciality Hospital, Thodupuzha, Kerala, India
Sancy Mary Sam Department of Pharmacology, Al Azhar Medical College and Super Speciality Hospital, Thodupuzha, Kerala, India
Sanitha Kuriachan Department of Pharmacology, Al Azhar Medical College and Super Speciality Hospital, Thodupuzha, Kerala, India
Nirmala Sethuraman Department of Pharmacology, Vinayaka Mission’s Kirupananda Variyar Medical College, Salem, Tamilnadu, India, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20182950

Keywords:

Lidocaine gel, Lidocaine drops, MSICS, Surgeon’s comfort, Topical anaesthesia

Abstract

Background: Cataract is a frequent surgical procedure performed worldwide. The study compared lidocaine 4% drops with 2% gel on surgeon’s comfort, need for supplemental anaesthesia and duration of surgery in patients who underwent manual small incision cataract surgery.

Methods: This was a Prospective, Comparison study conducted at a Single centre by multiple surgeons. Patients enrolled for surgeries were divided into Group A: Lidocaine 4% drops 1ml was instilled in the conjunctival sac 5 minutes before surgery and Group B: Lidocaine 2% gel 2ml was applied. Endpoints evaluated were surgeon’s comfort, need for supplemental anesthesia and duration of surgery.

Results: The mean duration of surgery for gel was 20±8 minutes as compared to 29±6 minutes with drops (p*- value<0.001). 26 (87%) patients in gel did not require any supplemental anesthesia as compared to 3 (10%) patients in drops. Peribulbar supplementation was required for 20 (67%) patients in drops as compared to 1 (3%) patient in gel (p*- value<0.001). 26 (87%) patients in gel were operated comfortably by the surgeon as compared to 2 (6%) patients in drops. Mild to Moderate discomfort was experienced by the surgeon in operating 27 (90%) patients in drops as compared to 3(10%) patients in gel (p*- value<0.001).

Conclusions: The surgeons were more comfortable using gel with least requirement of supplemental anaesthesia and faster completion compared to drops.

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